Download MBBS (Bachelor of Medicine, Bachelor of Surgery) Ophthalmology PPT 33 Lid Disorder Lecture Notes
Disorders of Lid
Anatomy
1. The skin
2. The subcutaneous areolar
tissue.
3. The layer of striated muscle.
4. Submuscular areolar tissue.
5. Fibrous layer.
6. Layer of non-striated muscle
fibres.
7. Conjunctiva.
The eyelid Margin
GLANDS OF EYELIDS
1. Meibomian glands.
q In tarsal plate arranged vertically.
qThese are modified sebaceous glands.
qTheir ducts open at the lid margin.
qTheir secretion constitutes the oily layer of tear film.
2. Glands of Zeis.
qThese are also sebaceous glands which open into the follicles of
eyelashes.
3. Glands of Moll.
qThese are modified sweat glands situated near the hair follicle.
qThey open into the hair follicles or into the ducts of Zeis
glands.
4. Accessory lacrimal glands of Wolfring.
qThese are present near the upper border of the tarsal plate.
Edema of lids
Inflammatory edema
Dermatitis, stye, insect bite, blepharitis
Passive edema
Renal disease, Cardiac failure,
Cavernous sinus thrombosis
INFLAMMATIONS OF THE EYELIDS
Blepharitis
1. Anterior blepharits.
2. Posterior blepharitis.
INFLAMMATIONS OF THE EYELIDS
Blepharitis
INFLAMMATIONS OF THE EYELIDS
1. Anterior blepharits
Squamous
Ulcerative
Treatment
Hot compress
Lid hygiene, cleaning with diluted baby shampoo
Topical : antibiotic, steroids, tear substitute
Oral : Azithromycin 500 mg OD for 3 days.
INFLAMMATIONS OF THE EYELIDS
Posterior blepharitis
Meibomian seborrhoea
Meibomianitis
Treatment:
Warm compress, lid hygiene & massage.
Oral doxycyclin or minocyclin for 6 wks.
INFLAMMATION OF GLANDS OF LIDS
Hordeolum externum or stye
Suppurative inflammation of gland of Zeis.
Hordeolum internum
Suppurative inflammation of meibomian gland
Chalazion
Chronic inflammatory granuloma of meibomian gland.
STYE (EXTERNAL HORDEOLUM)
STYE (EXTERNAL HORDEOLUM)
It is an acute suppurative inflammation of gland of the Zeis.
Causative organism commonly involved is Staphylococcus aureus.
Predisposing factors.
1. Refractive error
2. Blepharitis
3. Habitual rubbing of eyelids
4. Diabetes Mellitus
Symptoms and signs
Pain
Redness
Swelling
Watering
Other predisposing factors
Treatment
1. Hot fomentation
2. Antibiotic eye ointment
3. Anagesics
4. Oral antibiotics
5. Treatment of underlying cause
CHLAZION
CHLAZION
It is also called a tarsal or meibomian cyst.
It is a chronic non-infective granulomatous inflammation of
the meibomian gland.
Predisposing factors.
1. Refractive error
2. Blepharitis
3. Habitual rubbing of eyelids
4. Diabetes Mellitus
Clinical course and complications
Complete spontaneous resolution may occur rarely.
Occasionally, it may burst on the conjunctival side, forming a
fungating mass of granulation tissue.
Secondary infection leads to formation of hordeolum internum.
Calcification may occur, though very rarely.
Malignant change into meibomian gland carcinoma may be seen
occasionally in elderly patients.
Treatment
1. Conservative treatment.
2. Intralesional injection of long-acting steroid.
3. Incision and curettage.
4. Diathermy.
INTERNAL HORDEOLUM
It is a suppurative inflammation of the meibomian gland
associated with blockage of the duct.
It may occur as primary staphylococcal infection of the
meibomian gland or due to secondary infection in a chalazion
(infected chalazion).
Treatment. It is similar to hordeolum externum, except
that, when the pus is formed, it should be drained by a
vertical incision from the tarsal conjunctiva.
ANOMALIES IN POSITION OF THE
LASHES AND THE LIDS
Blepharospasm
Trichiasis
Entropion
Ectropion
Symblepharon
Ankyloblepharon
Blepharophimosis
Lagophthalmos
Ptosis.
Blepharospasm
Involuntary, sustained and forcible closure of lids.
Essential blepharospasm
Reflex blepharospasm
Treatment: Botulinum toxin
Facial denervation
Trichiasis
Misdirection of cilia, directed backwards to rub cornea.
Trachoma, blepharitis, scars, chemical burns, Steven-
Johnson synd,
Treatment: Epilation, Electrolysis, Cryosurgery, Argon laser
application.
Thank You
This post was last modified on 07 April 2022